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HomeMy WebLinkAboutBuilding Permit #304-13 - 197 MASSACHUSETTS AVENUE 10/15/2012 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: I� Date Received Date Issued: Th 4pnlDTANT: Applicant must complete all items on this page 05 1 71 y Pnn # r { 'PROPaERTIYf®WNERr_ p J Pnri 100YearOld St�ucturei yes nog jMAPN®s, PARCEL ZONING DISTRI4CT �HrstonelDlstrict ye;a 1no) IVlachine Sho.W llageLL ye riot I TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building )itone family ❑Addition ❑Two or more family ❑ Industrial El,,Alteration No. of units: El Commercial -)(Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Y 175eWell� rsFloodpla71 m ❑klNetlarids ,s❑ Watershed Dlsfrict ®�W_ater/S;e_weri DESCRIPTION OF WORK TO BE PERFORMED: �e�� �s-�h S�►rh ��5 Ide tiff n Please Type or Print Clearly) OWNER: Name: Phone: b/60?_ F� J Address: C®NR�ACTQR IVB me. ri'•�%�� r-r. -. +o--".f.r n.a...tea- _ see=.av„i.••:yFs..ati.c-sccr-..—m — T.;� _ ....emo+rwie - a S _ e i z SupenrlsojsCorstructlon�LlcenseCFD'ate J Home Irn rovernent License ) Q` a _ _• M,PIT . _s_ =' �t... ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ /SU U,, (�U FEE: $ Check No.: � Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access t the guarantyfund Slf� na re ofA ent/Owneri4.` - = Si nature�of'contractor'_ °h x Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ . TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS i 1 CONSERVATION Reviewed on Signature COMMENTS i HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town]Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT TempDumpster on site yes L ' 1 f Located 6'_t!4 24 M` *^. s .r:6.t.`yi"n� ,,atsa ♦ X+2.S- °3cst'� daaten Fire Department `r �i signature/ 4 � ��� > s4 .xrit" ° ., „. + n , COIVIIVIEIVTSk.4' i �R Aat � t � {7r� �l •: .€F.rf. d vx y i,a� �[f .Ylsj+ y �gyq d Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— (For department use ti r El Notified for pickup - Date t Doc.Building Permit Revised 2010 [[[ Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Doc.Building Permit Revised 2012 Location � ' ! 7117 No. Date ( � +� IZ— •-` J • • TOWN OF NORTH ANDOVER w ` ..a Certificate of Occupancy $ Building/Frame Permit Fee * Foundation Permit Fee " $ Other Permit Fee $ TOTAL $ `16 A /599 Check -t 25831 Building Inspector NORTy F ownT- .-O 1 6 n ove r No. _ _ h ver, Mass O LAKE .f_ Coc"Ic"t-ock V 7,9 p°R.4reo S U BOARD OF HEALTH Food/Kitchen PERMIT T 'Raw LD Septic System THIS CERTIFIES THAT BUILDING INSPECTOR .........777K...................................................I.................. has permission to erect .......................... buildings on ...Is.-I.....tia A-4fo.A4ss..... .................... Foundation Rough to be occupied as .... Q.. QQ ... ...:...ANW111►..... .... �A .�.�............................ Chimney provided that the person accepting this permits hall in every respect confoWto the terms of thea application pp Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. _ PLUMBING INSPECTOR ' VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO S T Rough Service ...................... ............. .......................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE Hi-Tech Window & Siding, Inc. ROOFING SINE 143 Washington Street, Haverhill, MA 01832 e3S MA Lic. # 016201 1-800-851-0900 S MA Reg. # 118836 9 � ap `�11 m www.hitechcorp.biz W BBB A J Dater/ 63 1 !2 MEMBER Consultant: ` f Job Name: c' / Telephone: d Job Address: 19 i, (SS Town: N�A�V op yr agrees to start described work on/or about weeks after final fittings and fomplete described work in about working days. CONTRACTOR shall not be held liable for delays due to causes beyond our control.-Hi-Tech shall not be held liable for an damage to lawn r planf!s The following work includes all labor and materials needed to complete your job in a workmanshiplike man er. 1//. �j � w. Job lnclutles: !. !ce Antl aier Shleld To Be Done IQ Co bination Job-Roofing With Other Work 1 S 3'Feet Eaves Q 1,S0'Feet Rakes g6Lfding Permit emoving Existing Shingles All Valleys Around Chimney 8 Point Guarantee Program [},Starter Wind Shingles round Vent Pipes Q Other Q Going over Existing Shingles E4 Underlayment Q New Hug Edge New Drip Edge Venting To$e DOne a Q Venting Ice Water Shield Q Install Ridge Vent Q Install Ro`bf Vents Q Sealing Q Ridge Vent Q Install Soffit Vents Q Install Roof Fan Q Gutter Work Q Gutter Cleaning Q Other Q Install Skylights emoving Debris in a Legal Manner Type Roof Rernova!YI►ork 70 Be:tDone Location Q No oof Removal .................. . emove m fete&use Q Remove Complete Garage Gutter Work To'Be dpne /1 �h#1413 plvth Locations to H e . Q 1 Layer Removal2 ayer Removal Supply Dumpster 30 Yarder Q 20 Yarder Q No New Gutter Xrk To Be Done Dumpster Lo ation: f, Q Clean Gutter iter Removal q Q Gutter Removal In II Root Und rlayment To All Areas Re oved Q Seamless Gu r Color eplace Roof Boards As needed-Extra Charge as Needed Q Pipe Color Roof AreBs,To lie done`: Q Fascia W omplete Houpe Complete Garage Q Gutter Guard Q Water Fall System Q Englert System Other ( (/ P d ofZ SpBctat Not8s U M 9r PO111c Rooflr3g Material Tow Usetf. .: Manufacturer. 0 Style. L Shingle Color: f (ll Q Tab Shingle Architectural r Fiberglass Q rganicTit /1 5 /( Q 25 Year Shingle 30.Year Shingle II Work Area To Be Left Broom Clean it Q 40 Year Shingle Q 50 Year Shingle ,Payfnent Pohcyr; Dr ,Ett'+a AnBank Financing Q Owner To Arrange Q Hi-Tech To Arrange CJ Install 8"Drip Ede Q Install 5"Drip Ede Color Q Cash Or Check Q Master Card Q Install 5"Hug Edge- (Go Overs Only) Color Q Re-Seal Vent Pie Q lace Vent Pie Flange Total Investment OU, UU Q Re-Seal Chimney Base Re-Lead Chimney 1/3 Deposit 00. 0 d O Repoint Chimney- Roof Up Step Flash As Needed 1/3 Payment At 1/2 Way 1/3 Balance Day Of Completion 5000, 00 You may cancel this agreement if it has been signed by a party thereto at a place other than the address of the seller, which may be his main office or branch thereto, provided you notify the seller in writing at his main office or branch by ordinary mail posted, by telegram sent, or by delivery, not later than midnight of the third business day following the signing of this agree- ment. See the attached notice of cancellation form for an explanation of this right. � An interest charge of 1 1/2% per month (18% per year) will be Date of Acce ree�"' Gf added to any amount unpaid after 30 days from invoice date. Signature In the event of default in payment of this order or any part thereof and the account is (Homeown referred to an attorney for collection,the purchaser agrees to pay reasonable attorney fees. Signature (HiTech) iii?/�C11 g,10:1 AM PST (G4T-0; FROM: ir_suran��v__ �, _ 37160_ Forge: 2 of 21 ACfORI > CERTIFICATE OF LIABILITY INSURANCE DATEMrAl orM THIS CERTIFlCATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the Dol' the terms and conditions of the policy,certain `� ) must be endorsed. If SUBROGATION IS WAIVED,subject to policies may require an endorsement, t*,this certificate does not confer rights to the certificate holder in lieu of such endorseme s, A statement PRODUCER BARRY J KITTREDGE INSURANCE 81 S MAIN ST 9ONTACT NAME: BRADFORD, MA 01.835'-- PHONE(&C No tI X978)374-8400 c No� 978 73-3360 _._...___.._..._._._.-- EAWL ADDRESS: INSURERS AFFORDING CO-VERAGE NMCS NSURED NSURERA.: LIBERTY M LI TU AL GROUP HI TECH WINDOW& SIDING INSTALLATIONS INC NSURERa: PO BOX 8234 INSURER C HAVERHILL MA 01835 NSURERO: INSURER I— COVERAGES nstnLER F CERTIFlCATE NUMBER: 11817554 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISS REVISION NUMBER:INDC CERTIFICATE NOTWITHSTANDING O ANY REQUIREMENT• TERM OR CONDITION OF ANY CONTRACT OR OTHER EDOCUMENT WITH RESPTHE POLICY ECT TO WHICH PERIOD CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED-HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR SUSIR -- LTR TYPE Of INSURANCE POLICY EFT: POLICY NUMBER POLICY EXP GENERAL LIABR.fTY I LIMITS COMMERCIAL GENERAL L"UTY I EACH OCCURRENCE $ Fit 4l TO R9rTED CLAWSaAADE E1OCCUR I ! SE6 a o=owce S WD EXP(Any one person) S i PERSONAL&ADV INJURY $ GENt AGGREGATE LIMB APPLIES PER. GENERAL AGGREGATE $ PCL:CY PRO- LOC I PRODUCTS.COMPIOP AGG $ AUTOMOeI_E LIABILITY S I � ANY AUTO I I e eccm'ALL $ AUTCWNED ASCI*MLED I BODILY INJURY(Par•Person) $ HIRED AUTOS NON-CWNEO I BOOILY INJURY(Per ecddeM) $ AUTCS R (Pat acddentDA1 U $ I I , S, UMaRELLA LIAE OCCUR ' S , EXCESS LIAR CLA W-MADE EACH OC'CURkENCE $ DED RETENTIONS I AGGREGATE $ I S A WORKERS COMPEN&nom $ AMC EMPLOYE RSL1AWLJTY Y/N WC2-31S-383602-01 11/2912011 i 11/29/2012 I WCRTATU- ANY PROPRIETORA ARTNEREXECL'TtVE r✓ TORY IMRS OFTICERMEMBER EXCLUDED? Ni A Mandabry in NN) I El EACH ACCIDENT S 100000If 0 OESCdesabe ndsr ElDISEASE.:EA EMPLOYE S DESCRPTIGN pF Cr ERATpNS Ceio v I i Ea DISEASE.POLICv LMR $ 100000 I I DESCRIPTION OF OPERATIONS f LOCATK>rr3 1 VEHK'LES (Attach ACORD 101,Addlllot Rtrw fks Sdwdul. a non cprca 19 MgLirod) Workers Compensation Inst rance: Pari One of the Policy applies only to the Workers Compensation Law of the State of MA CER-LUTIFICATE HOLDER CANCEL T10N SHOULD ANY OF THE ABOVE DESCRIBED poLK3ES BE B THE EXPIRATION DATE THEREOF, ORE NOTICE VMBE CANCELLED DD BEEFIN ACCORDANCE WfT}i THE POLICY PROVMONS. AUTWAUZEp REPRESENTATIVE Jeff Eldridoe ACORD 25(2010105 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are reg)stered marks of ACORD ��'.t c±n.: 1a1755t CrL Cecr,,-n�cs�:, 12'9;201, 9:iA:09 AF: Faq� .L.S •:rtn(Leat_ cancels and Suporscdes ru.t Pr rvi' ly iss_ad crccct.�a;.�s. `j Office of Consumer Affairs and Efusiness Regulation 10 Park Plaza - Suite 5170 Boston Massacbusetts 02116 Home.Improvement Con tfactor Registration Registration: 118836 Type: Private Corporation MV / Expiration: 4/26/2013 Tr# 211404 L r� HI TECH WINDOW & SIDING INSTALL I!N, WILLIAM CHASE t t� '-iE P.O. BOX 8234 }1 == HAVERHILL, MA 01835 Update Address and return card.Mark reason for change. F� Address F-� Renewal Employment Lost Card ?' ;DPS-CA1 0 50M-04/04-G101216 a . �,_ •� ,� �,��' rv� was;. ,�,�" � :r; ,� r. t ( Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction SupervisHr License: CS-106508 WILLIAM CHASE-'II 29 ARROWWOOID STREET Methuen MA 01P4 Expiration Commissioner 09/23/2016 I v